0001209191-23-005702.txt : 20230131 0001209191-23-005702.hdr.sgml : 20230131 20230131162704 ACCESSION NUMBER: 0001209191-23-005702 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221231 FILED AS OF DATE: 20230131 DATE AS OF CHANGE: 20230131 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Patel Sanjiv CENTRAL INDEX KEY: 0001816210 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39385 FILM NUMBER: 23572903 MAIL ADDRESS: STREET 1: C/O RELAY THERAPEUTICS, INC. STREET 2: 399 BINNEY STREET CITY: CAMBRIDGE STATE: MA ZIP: 02139 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Relay Therapeutics, Inc. CENTRAL INDEX KEY: 0001812364 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 399 BINNEY STREET STREET 2: 2ND FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 617-370-8837 MAIL ADDRESS: STREET 1: 399 BINNEY STREET STREET 2: 2ND FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02139 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2022-12-31 0 0 0 0001812364 Relay Therapeutics, Inc. RLAY 0001816210 Patel Sanjiv C/O RELAY THERAPEUTICS, INC. 399 BINNEY STREET, 2ND FLOOR CAMBRIDGE MA 02139 1 1 0 0 President and CEO Common Stock 2022-10-28 5 G 0 254554 0.00 D 0 D Common Stock 2022-10-28 5 G 0 254554 0.00 A 687355 I By The SSP Irrevocable Trust of 2020 Common Stock 674548 I The Patel Family Irrevocable Trust of 2019 These shares are held in an irrevocable trust for the benefit of the reporting person's family members. An independent trustee is trustee of this trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. /s/ Brian Adams, as Attorney-in-Fact 2023-01-31